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Objective: To evaluate the longer-term safety and reintervention outcomes of mesh implants in pelvic organ prolapse (POP) repairs., Methods: We conducted a population-based cohort study of women undergoing POP repairs in inpatient and outpatient surgical settings between 2008 and 2016 in New York State. Multivariable logistic regression was used based on patient and procedural characteristics and hospital volume between mesh and nonmesh groups to obtain propensity scores for each individual. Long-term safety events and reinterventions were assessed using time-to-event analysis., Results: We identified 54,194 women undergoing POP repairs (12,989 with mesh, and 41,205 without mesh). Mean age was 59.8 (±13.1) years, and median follow-up was 4.7 years (interquartile range, 2.4-6.8 years). In the propensity score-matched 12,284 pairs of women, POP repair with mesh was associated with a higher risk of reintervention when compared with POP repair without transvaginal mesh (hazard ratio 1.40, 95% CI 1.27-1.54, P<.001). The estimated risk of undergoing a reintervention at 5 years was 8.8% (95% CI 8.2-9.3%) in the mesh group and 6.3% (5.9-6.8%) in the nonmesh group. Among patients who had reinterventions, 18.5% of those operated with mesh had a reintervention related to mesh-related complications., Conclusion: Even though transvaginal mesh has been removed from the market, the risk of mesh complications did not diminish over time and these women warrant close follow-up. Continued surveillance of mesh in POP repairs is essential to ensure safety for the women who have already been implanted.

A prospective study of the use of realtime and store-and-forward teleconsulting was carried out in patients who presented to the New York Eye and Ear Infirmary for otolaryngology care. Forty-five patients were seen in the study. There were no significant differences between local and remote otolaryngologists when interpreting the examinations, indicating that transmission did not affect the ability of a qualified physician to make an accurate diagnosis. In the store-and-forward examinations only 62% of the electronic records provided sufficient information for a confident diagnosis. Records were judged inadequate primarily due to poor selection, or an insufficient number of stored images. The study demonstrates that both interactive and store-and-forward techniques can be used to provide accurate clinical consultations in nasopharyngolaryngoscopic examinations. However, since store-and-forward consultations include less information and do not provide immediate feedback, as well defined clinical protocol for assembling the electronic consultation is needed.